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Request for a Change in Cluster Placement
By filling out this form, you are requesting a change in your child's cluster placement for the 2018/2019 school year. In order to complete this request, an administrator must approve the form, there has to be a valid reason for the move, and there must be room in the new cluster. You will be contacted regarding the status of your request once we are able to process it. PLEASE NOTE THAT THIS IS ONLY A REQUEST AND DOES NOT GUARANTEE A CHANGE IN PLACEMENT.
Grade (for NEXT school year):
Current cluster placement for 2018/2019 School Year:
REQUESTED cluster placement for 2018/2019 School Year:
Reason for change in placement:
Does your child receive any support services (Special Education, 504 Plan, ELL, Title I, etc.)?
What support service does your child receive?
My child does NOT receive any support services
Send me a copy of my responses.
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